2004 VOLUNTEER WATER QUALITY MONITORING
INTRODUCTORY LEVEL WORKSHOP REGISTRATION FORM

***Due to the high demand and limited space for these classes, individuals under the
age of 18 need to be accompanied by a sponsoring adult in order to attend.

Location and Date of Introductory Level Workshop you wish to attend:

________________________________________________________________

Name:___________________________________________________________

Address: _______________________________________________________

City, State, Zip: ______________________________________________

Telephone Number: ______________________________________________

Stream You would like to Monitor:
 ______________________________________________

County: __________________________________________________

Verbal or Legal Description of site monitored (e.g. upstream from Highway 70 bridge):

________________________________________________________________

STREAM TEAM/Organization/School Affiliation:

________________________________________________________________


Return to:
PRISCILLA STOTTS
Water Protection Program
Missouri Department of Natural Resources
P.O. Box 176
Jefferson City, MO 65102-0176